Abstract

Purpose

To evaluate the loco-regional control, survival and complications of the adjuvant postoperative treatment in the adenocarcinoma of endometrium.

Material and methods

Between 1985 and 1994, 208 patients with stage I, II and III were treated after surgery with brachytherapy in stage I with good prognosis, with pelvic external radiotherapy and brachytherapy the rest of the stages I and II, and with abdominal radiotherapy and brachytherapy in stage III. The minimum follow-up was three years.

Results

The overall and disease free survival (DFS) at 5 years was 88 and 89.6%, respectively. The group of patients with stage IB (G1-G2) (46 patients) treated with brachytherapy after the surgery, reached a DFS of 97.8% at 5 years, with a loco-regional control of 100%. In the group treated with pelvic external radiotherapy and brachytherapy the DFS at 5 years was of 86.9% and the rate of loco-regional relapses was of 3% (3/99). The DFS for stage IIIA was 80% and the incidence of abdominal failures was 19% (8/42). In the multivariate analysis the age, the stage and the differentiation degree were independent factors to predict the DFS. Complications happened in 28 patients (13.5%), being 82.3% grade 1.

Conclusion

The post-operative brachytherapy is an effective method to prevent the local relapses in the group of patient with stage I of good prognosis. The brachytherapy associated to external radiotherapy in the stage I and II of bad prognosis reduces the rate of loco-regional failures to 3%. The DFS in the stage IIIA with abdominal radiotherapy reaches 80% at 5 years.